Dr. W. Gifford-Jones: Beijing Trots And Other Travel Hazards In 2008?

Dr. W. Gifford-Jones

Monday

Apr 28, 2008 at 12:01 AMApr 28, 2008 at 5:40 PM

How many people will travel to China for the Olympics this summer or elsewhere on this planet? I don’t know. But I do know many will raise this silent prayer to the Almighty, “Please, above all other worldly goods, grant me a bathroom.”

How many people will travel to China for the Olympics this summer or elsewhere on this planet? I don’t know. But I do know many will raise this silent prayer to the Almighty, “Please, above all other worldly goods, grant me a bathroom.” Desperately needing a toilet is as close to panic as it gets when one isn’t available. But toilets can be the least of your worries if you fail to take other precautions when travelling.

To get an update on medical problems facing travelers I interviewed Dr. Jay Keystone, Professor of Medicine at the University of Toronto and Director of Medisys Travel Clinic in Toronto. He is emphatic that long before you pack your bag it’s prudent to obtain current protection from infectious disease.

Think “booster shots” as a start. Too many people fail to get shots for diphtheria, tetanus, whooping cough and polio. Polio came close to being wiped until Nigeria removed the vaccine due to worries that it was contaminated with the AIDS virus. So it’s still a risk in Africa and South Asia, but not yet at the Olympic site.

Malaria, a killer of millions, flourishes in the developing world, particularly in Africa. But even in the Caribbean you can contact malaria in Kingston, Jamaica, Dominican Republic and Haiti.

Dr. Keystone says that typhoid is an uncommon imported infection. But for those who immigrated to North America from a developing country and plan to return to their native land to visit relatives, it’s wise to be vaccinated against this disease. Or for adventuresome types who want to wander off the usual tourist routes.

It’s a rare traveler who thinks “rabies” prior to a trip. But Keystone reports that nearly 4,000 people die from rabies every year in China. The culprits are usually infected dogs. So if you and your children can’t resist petting dogs, get rabies vaccination as these animals roam Beijing. Rabies vaccine is also advisable if you plan to be in China for a prolonged visit.Some dogs don’t have to be petted to bite. But currently this vaccine is in short supply globally.

Dying from a disease you can’t prevent is one thing. But it’s tragic to succumb to one that should never happen. Hepatitis A is 100X more common than typhoid and 1,000 X that of cholera and it’s easily transmitted by contaminated food or the ice-cube in your drink. Most patients are ill for a couple of weeks and many experience dark urine, vomiting, fatigue and abdominal pain. But a few people also die, especially older travelers.

Hepatitis B is a world-wide problem affecting 50 million people. It results in two million deaths each year and is spread primarily by sexual contact or contaminated needles. The virus is present in all body fluids such as blood, semen, saliva, sweat and tears.
Hepatitis A and B both attack liver cells causing an initial inflammation. But there the similarity ends. With hepatitis A, once the acute infection subsides the virus is eliminated from the body and the patient has lifelong immunity to the disease.

Hepatitis B is not that generous. The virus can remain in the body and result in a chronic infection that may last a lifetime. And the longer the virus remains the greater the risk of developing cirrhosis or cancer of the liver. A vaccine called Twinrix now offers protection against both of these diseases.

The old saying “Do in Rome as the Romans do” is good advice to a point. But be aware of unaccustomed hazards. Don’t buy food from street vendors. Don’t put ice in your scotch-and-soda and wash your hands whenever you can. And as Dr Keystone stresses “If you can’t boil it, cook it or peel the food, don’t eat it”.

But even the most experienced travelers eventually fall victim to Montezuma’s revenge or the Beijing trots. That’s why I always carry an antibiotic for self-treatment and give myself an oral booster shot of Dukoral when I travel out of the country. Dukoral is highly effective against those bacteria that can make strong men cry when they can’t find a toilet.

See the Web site www.mydoctor.ca/gifford-jones

Dr. W. Gifford-Jones is actually Dr. Ken Walker, a practicing physician in Toronto who writes many columns at his Bristol Harbour, N.Y. residence.

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